A groundbreaking study conducted in Quebec shows that sexually abused girls have twice as many problems with urinary health and 1.5 times more genital disorders than teenage girls in general.

Published in the Journal of Pediatrics by researchers from Université de Montréal, the study also shows for the first time that sexual assault on children is linked with an increase in genito-urinary health problems in girls, but not in boys.

Researchers compared a group of 882 girls and boys who were abused during their childhood to a control group of young people of the same age.

In the 12 years following the abuse, sexually abused girls received 115 per cent more urinary health diagnoses and 40 per cent more genital health diagnoses than girls who were not abused. But in the case of boys, there seemed to be little difference in health problems in those who were assaulted compared to those who were not.

This gap between boys and girls and the impact on their sexual health came as a big surprise, said lead author, Pascale Vézina-Gagnon, a PhD student in UdeM’s department of psychology, and researcher in a laboratory specializing in the long-term health of young victims of sexual abuse, Laboratoire de recherche sur les trajectoires de santé et de résilience de jeunes agressés sexuellement (TRAJETS).

But that does not mean boys do not experience negative health consequences from sexual abuse, she explained.

Among the main diagnoses in girls, researchers noted problems with menstruation and pain during intercourse, also urinary infections, inflammation of the uterus, cervix and vulva. Just being a girl is a risk factor for genito-urinary disorders, Vézina-Gagnon said, and this anatomy has no parallel with boys.

One hypothesis is that boys tend to seek medical help less often, and complications from sexual abuse might arise later in life, she said. “It’s very rare for boys to manifest problems with their prostate, fertility and penis,” she noted. “These problems may appear later as adults. It is also possible that the effects of sexual abuse on boys show as other health issues, such as gastrointestinal, or they may have somatic symptoms, for example, headaches.”

The study revealed little difference in sexually transmitted diseases (STDs) between victims of abuse and the comparison group, which seems to contradict previous studies, Vézina-Gagnon said. However, their average age was 18 at the end of the study in 2013, which means they might have been too young to be sexually active, she added.

Researchers developed a portrait of the health impact on sexually abused children by criss-crossing data accumulated by the Quebec Health Insurance Board (RAMQ) and reports compiled by youth protection officials, who corroborated between 80 to 100 cases a year of sexual abuse on children between 2001 and 2011 at one youth protection centre. The children were between the ages of one and 17 years old, and had reported the abuse to youth protection at a group home in Quebec City.

The nature of the sexual assault was not specified in the databases. However, the director of youth protection estimates that 46 per cent of assaults were mostly molestation, like sexual touching and fondling, 17 per cent involved penetration or attempted penetration, and nine per cent were oral sex.

Researchers hope to expand the study to cover sexual assault reported to youth protection throughout Quebec group homes.

According to a 2006 Quebec report, about one male out of 10 (9.6%) and one female out of four (22.1%) reported having been a victim of one sexual assault before the age of 18. Childhood sexual abuse is so common, its consequences have been well documented. Victims are at increased risk for having mental health problems long after the abuse.

But little is known on how such trauma affects the body, said Vézina-Gagnon, a psychologist who is interested in the mind-body link. Vézina-Gagnon wondered whether the trauma of sexual abuse can be linked with physical health problems. Her study suggests she was right in her hypothesis that abuse can have long term effects on physical health.

“We cannot underestimate the impact of sexual abuse on victims,” she said of the clinical implications of the study. “Health professionals should be aware of this pre-disposition of victims to develop urinary and genital disorders. And to prevent chronic problems in adulthood, intervention should start early.”

The study was conducted under the supervision of UdeM psychology professor Isabelle Daigneault, a specialist in child sexual abuse, in conjunction with pediatric professor Jean-Yves Frappier, a specialist in sexual abuse at CHU Sainte-Justine, and Sophie Bergeron, a psychology professor and specialist in the treatment of gynecological pain.

It was funded by grants from the Quebec Ministry of Justice and the Fonds de recherche du Québec — Santé (Quebec Health Research Fund).

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